Advertisement

Therapeutic Coronary Ultrasound Angioplasty in Patients with Symptomatic Coronary Artery Disease

  • Christian Hamm
  • Jacobus Reimers
  • Wolfgang Steffen
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 178)

Abstract

Balloon angioplasty is the established treatment modality for patients with symptomatic single vessel and selected patients with multivessel coronary disease [1–3]. Technological advances in angioplasty equipment are responsible for the high initial success and low complication rates today. Accordingly, the list of indications for angioplasty was extended to patients with coronary disease previously not considered suitable for percutaneous interventions. However, balloons have limiting shortcomings under certain conditions, for example, in thrombotic, long, ostial, and calcified lesions. Another major drawback is the high rate of restenosis. In recent years new technologies have emerged that are currently not able to replace balloon angioplasty but that may have potential as adjunct devices. The therapeutic application of ultrasound energy has been under investigation for several years and has now reached the stage where it can be used in patients.

Keywords

Acute Myocardial Infarction Left Anterior Descend Right Coronary Artery Balloon Angioplasty Chronic Total Occlusion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    RITA Trial Participants. Coronary angioplasty versus coronary artery bypass surgery: The Randomized Intervention Treatment of Angina (RITA) trial. Lancet 341:573–580, 1993.CrossRefGoogle Scholar
  2. 2.
    Hamm CW, Reimers J, Ischinger T, Hamm CW, Reimers J, Ischinger T, Rupprecht HJ, Berger J, Bleifeld. A randomized study of coronary angioplasty compared with bypass surgery in patients with symptomatic multivessel coronary disease. N Engl J Med 331:1037–1043, 1994.PubMedCrossRefGoogle Scholar
  3. 3.
    King SB III, Lembo NJ, Hall EC, EAST investigators. The Emory Angioplasty vs. Surgery Trial (EAST): Analysis of baseline patient characteristics. N Engl J Med 331:1044–1049, 1994.PubMedCrossRefGoogle Scholar
  4. 4.
    Siegel RJ, Fishbein MC, Forrester J, Moore K, DeCastro E, Daykhowsky L, DonMichael TA. Ultrasound plaque ablation: A new method for recanalization of partially or totally occluded arteries. Circulation 78:1443–1448, 1988.PubMedCrossRefGoogle Scholar
  5. 5.
    Steffen W, Siegel RJ. Ultrasound angioplasty — a review. J Interv Cardiol 6:77–88, 1993.PubMedCrossRefGoogle Scholar
  6. 6.
    Siegel RJ, Gunn J, Ahsan A, Siegel RJ, Gunn J, Ashan A, Fishbein MC, Bowes RJ, Oakley D, Wales C, Steffen W, Campbell S, Nita H, Wills T, Silverton P, Myler RH, Cumberland DC. Use of therapeutic ultrasound in percutaneous coronary angioplasty: Experimental in vitro studies and initial clinical experience. Circulation 89:1587–1592, 1994.PubMedGoogle Scholar
  7. 7.
    Steffen W, Luo H, Nita H, Steffen W, Fishbein MC, Luo H, Lee DY, Nita H, Cumberland DC, Tabak SW, Carbonne M, Maurer G, Siegel RJ. High intensity, low frequency catheter delivered ultrasound dissolution of occlusive coronary artery thrombi: An in vitro and in vivo study. J Am Coll Cardiol 24:1571–1579, 1994.PubMedCrossRefGoogle Scholar
  8. 8.
    Rosenschein U, Bernstein JJ, Di Segni, Rosenschein U, Bernstein J, Di Segni E, Kaplinsky E, Bernheim J, Rozenszain LA. Experimental ultrasonic angioplasty: Disruption of atherosclerotic plaque and thrombi in vitro and arterial recanlization in vivo. J Am Coll Cardiol 15:711–717, 1990.PubMedCrossRefGoogle Scholar
  9. 9.
    Siegel RJ, Cumberland DC, Crew JR. Ultrasound recanalization of diseased arteries. From experimental studies to clinical application. Surg Clin North Am 74:879–897, 1992.Google Scholar
  10. 10.
    Siegel RJ, Cumberland DC, Myler RK, DonMichael TA. Percutaneous ultrasonic angioplasty: Initial clinical experience. Lancet 9:772–774, 1989.CrossRefGoogle Scholar
  11. 11.
    Siegel RJ, Nita H, Steffen W, Siegel RJ, Nita H, Steffen W, Fishbein MC, Passafaro J. Development of a flexible over-the-wire ultrasound coronary ablation catheter (abstr). Circulation 86(Suppl I):I457, 1992.Google Scholar
  12. 12.
    Gunn J, Wales C, Baig W, Siegel RJ, Cumberland D. Ultrasonic angioplasty for chronic total coronary artery occlusion. Lancet 344:1225, 1994.PubMedCrossRefGoogle Scholar
  13. 13.
    Hamm CW, Reimers J, Köster R, Terres W, Stiel GM, Koschyk DH, Kuck KH, Siegel RJ. Coronary ultrasound thrombolysis in a patient with acute myocardial infarction. Lancet 343:605, 1994.PubMedCrossRefGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1996

Authors and Affiliations

  • Christian Hamm
  • Jacobus Reimers
  • Wolfgang Steffen

There are no affiliations available

Personalised recommendations